OBRA Philosophy
The federal Nursing Home Reform Act of 1987, which was part of the Omnibus Budget Reconciliation Act of 1987, became known in the nursing home industry as OBRA.
The key aspects of the OBRA legislation that should guide the design of nursing homes.
Holistic focus on the individual resident - their unique interests, abilities, and needs.
I. Maximize the quality of life for each resident
A. Maintain or improve well-being including:
1. General physical and mental health
2. Functional status
3. Self-esteem
4. Relationships
5. Appearance
B. Protect and enhance resident rights including:
1. Privacy
2. Participation in care planning
3. Accommodation of individual needs
4. Freedom from chemical and physical restraints
5. Opportunity to organize and participate in resident and community groups
6. Opportunity to voice grievances
7. Opportunity to review own medical records
C. Assure personal autonomy including:
1. Availability of choices
2. Self-determination
3. Access to assistance
II. Maximize the quality of care given each resident
A. Deliver individualized care with respect.
B. Base care on periodic comprehensive assessment, including capabilities and weaknesses.
C. Provide care needed to attain and maintain highest practical level of well-being.
D. Provide care by qualified staff 24 hours/day.